Research Progress on the Relationship Between Sarcopenia and Pain
DOI:
https://doi.org/10.62836/amr.v5i1.0004Keywords:
sarcopenia, pain, elderlyAbstract
With the global population aging rapidly, the prevalence of age-related conditions such as sarcopenia and chronic pain is increasing. Sarcopenia is a progressive skeletal muscle disorder characterized by loss of muscle mass and function, while pain, particularly musculoskeletal pain, is a common geriatric syndrome. Although both conditions are associated with reduced physical activity and functional decline, their direct relationship remains unclear. This review synthesizes current evidence on the correlation between pain and sarcopenia. Epidemiological studies reveal a complex and often bidirectional association influenced by demographic factors such as age, gender, and living environment. Pain may contribute to the development of sarcopenia by limiting mobility and physical activity, while sarcopenia-related muscle degeneration and fat infiltration may exacerbate pain symptoms. Potential underlying mechanisms include chronic inflammation driven by pro-inflammatory cytokines (e.g., TNF-α, IL-6), malnutrition, and reduced anabolic hormone levels. However, findings are inconsistent across studies due to differing diagnostic criteria and population characteristics. While a direct causal link has not been established, the indirect correlation between pain and sarcopenia suggests that integrated assessment and management of both conditions could improve outcomes in elderly populations. Further longitudinal research is needed to clarify their pathophysiological relationship.
References
Samoilova YG, Matveeva MV, Khoroshunova EA, et al. Markers for the Prediction of Probably Sarcopenia in Middle-Aged Individuals. Journal of Personalized Medicine 2022; 12(11): 1830.
Iwahashi S, Hashida R, Matsuse H, et al. The Impact of Sarcopenia on Low Back Pain and Quality of Life in Patients with Osteoporosis. BMC Musculoskeletal Disorders 2022; 23(1): 142.
Wu WT, Lee TM, Han DS, et al. The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease-A Systematic Review and Meta-Analysis. Journal of Clinical Medicine 2021; 10(4): 773.
Sakai Y, Matsui H, Ito S, et al. Sarcopenia in Elderly Patients with Chronic Low Back Pain. Osteoporosis and Sarcopenia 2017; 3(4): 195–200.
Han DS, Wu WT, Hsu PC, et al. Sarcopenia Is Associated with Increased Risks of Rotator Cuff Tendon Diseases Among Community-Dwelling Elders: A Cross-Sectional Quantitative Ultrasound Study. Frontiers in Medicine 2021; 8: 630009.
Imai R, Imaoka M, Nakao H, et al. Association between Chronic pain with Presarcopenia and Central Sensitization in Japanese Community-Dwelling Older Adults: A Cross-Sectional Study. Medicine 2022; 101(32): e29998.
Han YA, Kwon HJ, Lee K, et al. Impact of Sarcopenia on Percutaneous Epidural Balloon Neuroplasty in Patients with Lumbar Spinal Stenosis: A Retrospective Analysis. Medicina 2023; 59(5): 847.
Li H, Li J, Ma Y, et al. The Effect of Sarcopenia in the Clinical Outcomes Following Stand-Alone Lateral Lumbar Interbody Fusion. Journal of Back and Musculoskeletal Rehabilitation 2021; 34(3): 469–476.
Chua M, Hochberg U, Regev G, et al. Gender Differences in Multifidus Fatty Infiltration, Sarcopenia and Association with Preoperative Pain and Functional Disability in Patients with Lumbar Spinal Stenosis. The Spine Journal 2022; 22(1): 58–63.
Daglish J, Mama KR. Pain: Its Diagnosis and Management in the Rehabilitation of Horses. Veterinary Clinics: Equine Practice 2016; 32(1): 13–29.
Tsuji H, Tetsunaga T, Tetsunaga T, et al. Evaluation of SARC-F and SARC-CalF for Sarcopenia Screening in Patients with Chronic Musculoskeletal Pain: A Prospective Cross-Sectional Study. Medicine 2022; 101(29): e29568.
Cohen SP, Vase L, Hooten WM. Chronic Pain: An Update on Burden, Best Practices, and New Advances. Lancet 2021; 397(10289): 2082–2097.
Kim HJ, Ban MG, Yoon KB, et al. Neuropathic-Like Pain Symptoms and Their Association with Muscle Strength in Patients with Chronic Musculoskeletal Pain. Journal of Clinical Medicine 2022; 11(18): 5471.
Lee D, Kang M. Correlation between Psoas Muscle Index and Degeneration of Spinal Back Muscle in Patients with Back Pain. Healthcare 2021; 9(9): 1189.
Batista PP, Perracini MR, Amorim JSC, et al. Prevalence Risk of Sarcopenia in Older Brazilian Adults during the Pandemic: A Cross-Sectional Analysis of the Remobilize Study. Sao Paulo Medical Journal 2022; 141(4): e2022159.
Scott D, Blyth F, Naganathan V, et al. Prospective Associations of Chronic and Intrusive Pain with Sarcopenia and Physical Disability Amongst Older Australian Men: The Concord Health and Ageing in Men Project. Experimental Gerontology 2021; 153: 111501.
Kim WJ, Kim KJ, Song DG, et al. Sarcopenia and Back Muscle Degeneration as Risk Factors for Back Pain: A Comparative Study. Asian Spine Journal 2020; 14(3): 364–372.
Tanishima S, Hagino H, Matsumoto H, et al. Association between Sarcopenia and Low Back Pain in Local Residents Prospective Cohort Study from the GAINA Study. BMC Musculoskeletal Disorders 2017; 18(1): 452.
Tsuji S, Shinmura K, Nagai K, et al. Low Back Pain Is Closely Associated with Frailty but Not with Sarcopenia: Cross-Sectional Study of Rural Japanese Community-Dwelling Older Adults. Geriatrics & Gerontology International 2021; 21(1): 54–59.
Liao CD, Chen HC, Huang SW, et al. Impact of Sarcopenia on Rehabilitation Outcomes after Total Knee Replacement in Older Adults with Knee Osteoarthritis. Therapeutic Advances in Musculoskeletal Disease 2021; 13: 1759720x21998508.
Wada T, Tanishima S, Osaki M, et al. Relationship between Sarcopenia and Pain Catastrophizing in Patients with Lumbar Spinal Stenosis: A Cross-Sectional Study. Osteoporosis and Sarcopenia 2019; 5(4): 132–136.
Kim HI, Ahn SH, Kim Y, et al. Effects of Sarcopenia and Sarcopenic Obesity on Joint Pain and Degenerative Osteoarthritis in Postmenopausal Women. Scientific Reports 2022; 12(1): 13543.
Papadopoulou SK. Sarcopenia: A Contemporary Health Problem among Older Adult Populations. Nutrients 2020; 12(5): 1293.
Scott D, Blizzard L, Fell J, et al. Prospective Study of Self-Reported Pain, Radiographic Osteoarthritis, Sarcopenia Progression, and Falls Risk in Community-Dwelling Older Adults. Arthritis Care & Research 2012; 64(1): 30–37.
Bo J, Zhao X, Hua Z, et al. Impact of Sarcopenia and Sagittal Parameters on the Residual Back Pain after Percutaneous Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fracture. Journal of Orthopaedic Surgery and Research 2022; 17(1): 111.
Imagama S, Ando K, Kobayashi K, et al. Risk Factors for Neuropathic Pain in Middle-Aged and Elderly People: A Five-Year Longitudinal Cohort in the Yakumo Study. Pain Medicine 2020; 21(8): 1604–1610.
Ohyama S, Hoshino M, Takahashi S, et al. Presence of Sarcopenia Does Not Affect the Clinical Results of Balloon Kyphoplasty for Acute Osteoporotic Vertebral Fracture. Scientific Reports 2021; 11(1): 122.
Eguchi Y, Suzuki M, Yamanaka H, et al. Associations between Sarcopenia and Degenerative Lumbar Scoliosis in Older Women. Scoliosis and Spinal Disorders 2017; 12: 9.
Facciorusso A, Antonino M, Muscatiello N. Sarcopenia Represents a Negative Prognostic Factor in Pancreatic Cancer Patients Undergoing EUS Celiac Plexus Neurolysis. Endoscopic Ultrasound 2020; 9(4): 238–244.
Bonanni R, Gino Grillo S, Cariati I, et al. Osteosarcopenia and Pain: Do We Have a Way Out? Biomedicines 2023; 11(5); 1285.
Hishikawa N, Toyama S, Sawada K, et al. Foot orthosis Treatment Improves Physical Activity but Not Muscle Quantity in Patients with Concurrent Rheumatoid Arthritis and Sarcopenia. Modern Rheumatology 2021; 31(5): 997–1003.
Koca I, Savas E, Ozturk Z A, et al. The Evaluation in Terms of Sarcopenia of Patients with Fibromyalgia Syndrome. Wiener klinische Wochenschrift 2016; 128(21–22): 816–821.
Ramoo K, Hairi NN, Yahya A, et al. Longitudinal Association between Sarcopenia and Cognitive Impairment among Older Adults in Rural Malaysia. International Journal of Environmental Research and Public Health 2022; 19(8): 4723.
Basat S, Sivritepe R, Ortaboz D, et al. The Relationship Between Osteoarthritis and Sarcopenia in Geriatric Diabetic Patients. Medical Bulletin of Sisli Etfal Hospital 2021; 55(4): 516–523.
Veronese N, Punzi L, Sieber C, et al. Sarcopenic Osteoarthritis: A New Entity in Geriatric Medicine? European Geriatric Medicine 2018; 9(2): 141–148.
Maruya K, Fujita H, Arai T, et al. Sarcopenia and Lower Limb Pain Are Additively Related to Motor Function and a History of Falls and Fracture in Community-Dwelling Elderly People. Osteoporosis and Sarcopenia 2019; 5(1): 23–26.
McKenzie JC, Wagner SC, Sebastian A, et al. Sarcopenia Does Not Affect Clinical Outcomes Following Lumbar Fusion. Journal of Clinical Neuroscience 2019; 64: 150–154.
Perna S, Alalwan T A, Al-Thawadi S, et al. Evidence-Based Role of Nutrients and Antioxidants for Chronic Pain Management in Musculoskeletal Frailty and Sarcopenia in Aging. Geriatrics 2020; 5(1); 16.
Martel‐Duguech L, Alonso‐Jimenez A, Bascuñana H, et al. Prevalence of Sarcopenia after Remission of Hypercortisolism and Its Impact on HRQoL. Clinical Endocrinology 2021; 95(5): 735–743.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Jiachun Li, Yu Liu, Jiye Liu, Haoran Wang
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommerical-NoDerivatives 4.0 International License.
